Date of Adoption: October 7, 1999.

Purpose: These rules will change the current annual license renewal for physicians and physician assistants to once every two years. In addition, the continuing medical education cycles will also be revised from three to four years for physicians and from one to two years for physician assistants.

Citation of Existing Rules Affected by this Order: Amending WAC 246-919-430, 246-919-450, 246-919-460, 246-919-990, 246-918-171, and 246-919-990.

Statutory Authority for Adoption: RCW 18.71.017 and 18.130.050(1).

Other Authority: RCW 18.130.040(4), 18.130.050(12), and 18.130.340.

Adopted under notice filed as WSR 99-18-085 on August 1 [31], 1999.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 2, Amended 5, Repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 2, Amended 5, Repealed 0.

Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 2, Amended 5, Repealed 0. Effective Date of Rule: January 1, 2000.

October 27, 1999

Bonnie King

Executive Director

OTS-2838.6

NEW SECTION
WAC 246-919-421
Renewal and continuing medical education cycle revision.

Beginning January 1, 2000, the one-year renewal cycle for physicians will transition to a two-year cycle and a four-year continuing medical education reporting cycle. The renewal and continuing medical education reporting cycle will be as follows:

(1) Effective January 1, 2000, any physician whose birth year is an even number will renew their credential for twenty-four months and every two years thereafter. Those physicians must obtain two hundred hours of continuing medical education within the next forty-eight months from the date of the initial two-year license and every four years thereafter.

(2) Effective January 1, 2001, any physician whose birth year is an odd number will renew their credential for twenty-four months and every two years thereafter. Those physicians must obtain two hundred hours of continuing medical education within the next forty-eight months from the date of the initial two-year license and every four years thereafter.

(3) Effective January 1, 2000, in order to attain full license status, individuals with a post-graduate limited license will pay the fee difference between the limited license application and the full license application. This license will expire on their second birthdate after issuance and every two years thereafter.

(4) Effective January 1, 2000, those physicians on a retired active status will remain on the annual renewal cycle and a four-year continuing medical education reporting cycle. Those retired active physicians must report two hundred hours of continuing medical education within the next forty-eight months and every four years thereafter.

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(1) Licensed physicians must complete ((one)) two hundred ((fifty)) hours of continuing education every ((three)) four years as required in chapter 246-12 WAC, Part 7.

(2) In lieu of the ((one)) two hundred ((fifty)) hours of continuing medical education, the commission will accept a current Physician's Recognition Award from the American Medical Association or a current certificate from any specialty board approved by the American Board of Medical Specialties (ABMS) which is considered by the specialty board as equivalent to the ((one)) two hundred ((fifty)) hours of continuing medical education required under WAC 246-919-430(1).  The commission will also accept certification or recertification by a specialty board as the equivalent of ((one)) two hundred ((fifty)) hours of continuing medical education.  A list of the approved specialty boards are designated in the 1995 Official American Boards of Medical Specialty Director of Board Certified Medical Specialist and will be maintained by the commission.  The list shall be made available upon request.  The certification or recertification must be obtained in the ((three)) four years preceding application for renewal.

[Statutory Authority: RCW 43.70.280.  98-05-060, § 246-919-430, filed 2/13/98, effective 3/16/98.  Statutory Authority: RCW 18.71.017 and 18.71A.020.  96-03-073, § 246-919-430, filed 1/17/96, effective 2/17/96.]

((The licensee may earn all one hundred fifty credit hours in Category I.  If the licensee does not earn the one hundred fifty credit hours in Category I, the licensee must earn the total of one hundred fifty credit hours in at least three of the five categories.))  The following are categories of creditable continuing medical education activities approved by the commission:

Category I	Continuing medical education activities with accredited sponsorship
Category II	Continuing medical education activities with nonaccredited sponsorship (maximum of ((sixty)) eighty hours)
Category III	Teaching ((medical)) of physicians or ((the)) other allied health ((services)) professionals (maximum of ((sixty)) eighty hours)
Category IV	Books, papers, publications, exhibits (maximum of ((sixty)) eighty hours)
Category V	((Nonsupervised)) Self-directed activities: Self-assessment, self-instruction, specialty board examination preparation, quality of care and/or utilization review (maximum of ((sixty)) eighty hours).

[Statutory Authority: RCW 18.71.017 and 18.71A.020.  96-03-073, § 246-919-450, filed 1/17/96, effective 2/17/96.]

(1) The credits must be earned in the ((thirty-six)) forty-eight-month period preceding application for renewal of licensure.

(2) Category I: Continuing medical education activities with accredited sponsorship. ((A maximum of one hundred fifty credit hours may be earned in Category I.))  The commission has approved the standards adopted by the Accreditation Council for Continuing Medical Education or its designated interstate accrediting agency, the Washington State Medical Association, in accrediting organizations and institutions offering continuing medical education programs, and will accept attendance at such programs offered by organizations and institutions offering continuing medical education programs, and will accept attendance at such programs offered by organizations and institutions so recognized as Category I credit towards the licensee's continuing medical education requirement for annual renewal of licensure. The licensee may earn all two hundred credit hours in Category I.

(3) Category II: Continuing medical education activities with nonaccredited sponsorship. A maximum of ((sixty)) eighty credit hours may be earned by attendance at continuing medical education programs that are not approved in accordance with the provisions of Category I.

(4) Category III: Teaching ((medical)) of physicians or ((the)) other allied health ((services)) professionals. A maximum of ((sixty)) eighty credit hours may be earned for serving as an instructor of medical students, house staff, other physicians or allied health professionals from a hospital or institution with a formal training program if the hospital or institution has approved the instruction.

(5) Category IV: Books, papers, publications, exhibits.

(a) A maximum of ((sixty)) eighty credit hours may be earned under Category IV, with specific subcategories listed below.  Credit may be earned only during the ((thirty-six)) forty-eight-month period following presentations or publications.

(b) Ten credit hours may be claimed for a paper, exhibit, publication, or for each chapter of a book that is authored and published.  A paper must be published in a recognized medical journal.  A paper that is presented at a meeting or an exhibit that is shown must be to physicians or allied health professionals.  Credit may be claimed only once for the scientific materials presented.  Credit should be claimed as of the date materials were presented or published.

Medical editing can not be accepted in this or any other category for credit.

(6) Category V: ((Nonsupervised.)) Self-directed activities.

(a) A maximum of ((sixty)) eighty credit hours may be earned under Category V.  ((Credit may be earned only for the thirty-six-month period following the year in which the study, preparation, care and/or review occurred.))

(b) Self-assessment: Credit hours may be earned for completion of a multimedia medical education program.

(c) Self-instruction: Credit hours may be earned for the independent reading of scientific journals and books.

(d) Specialty board examination preparation: Credit hours may be earned for preparation for specialty board certification or recertification examinations.

(e) Quality care and/or utilization review: Credit hours may be earned for participation on a staff committee for quality of care and/or utilization review in a hospital or institution or government agency.

[Statutory Authority: RCW 43.70.280.  98-05-060, § 246-919-460, filed 2/13/98, effective 3/16/98.  Statutory Authority: RCW 18.71.017 and 18.71A.020.  96-03-073, § 246-919-460, filed 1/17/96, effective 2/17/96.]

(1) Licenses must be renewed every two years on the practitioner's birthday as provided in chapter 246-12 WAC, Part 2, except postgraduate training limited licenses and retired active physician licenses.

(2) Postgraduate training limited licenses must be renewed every year to correspond to program date.

(3) Retired active physician licenses shall be renewed every year.

(4) The following nonrefundable fees will be charged:

Title of Fee	Fee
Physicians and surgeons: Chapter 18.71 RCW
Application	$300.00
Retired active physician license renewal (which is the $100.00 renewal fee plus $25.00 substance abuse monitoring surcharge)	125.00
Retired active late renewal penalty	50.00
One-year renewal	200.00
Two-year renewal	400.00
Late renewal penalty	((50.00)) 100.00
Expired license reissuance	((100.00)) 200.00
Substance abuse monitoring surcharge (assessed at $25.00 each year as stipulated in RCW 18.71.310(2))	((25.00)) 50.00
Certification of license	50.00
Duplicate license	15.00
Temporary permit	50.00
Postgraduate limited license fees: RCW 18.71.095
Limited license application	200.00
Limited license renewal	200.00
Substance abuse monitoring surcharge	25.00
Limited duplicate license	15.00

[Statutory Authority: RCW 43.70.280.  98-05-060, § 246-919-990, filed 2/13/98, effective 3/16/98.  Statutory Authority: RCW 18.71.017 and 43.70.250.  97-15-100, § 246-919-990, filed 7/21/97, effective 8/21/97.  Statutory Authority: RCW 18.71.017 and 18.71A.020.  96-03-073, § 246-919-990, filed 1/17/96, effective 2/17/96.]

OTS-2837.3

NEW SECTION
WAC 246-918-171
Renewal and continuing medical education cycle revision.

Beginning January 1, 2000, the one-year renewal cycle for physician assistants will transition to a two-year cycle and two-year continuing medical education cycle. The renewal and continuing medical education will be as follows:

(1) Effective January 1, 2000, any physician assistant whose birth year is an even number will renew their credential for twenty-four months and every two years thereafter. Those physician assistants must obtain one hundred hours of continuing medical education within the twenty-four months following the date their first two-year license is issued and every two years thereafter.

(2) Effective January 1, 2001, any physician assistant whose birth year is an odd number will renew their credential for twenty-four months and every two years thereafter. Those physician assistants must obtain one hundred hours of continuing medical education within the twenty-four months following the date their first two-year license is issued and every two years thereafter.

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OTS-3333.2

AMENDATORY SECTION(Amending WSR 99-13-087, filed 6/14/99, effective 7/15/99)

WAC 246-918-990
Fees and renewal cycle.

(1) Licenses must be renewed every two years on the practitioner's birthday as provided in chapter 246-12 WAC, Part 2.

(2) The following nonrefundable fees will be charged:

Title of Fee	Fee
Physician(('s)) assistants, certified physician assistants, physician assistant-surgical assistants, acupuncture physician assistants:
Application	$50.00
One-year renewal	((35.00)) 70.00
Two-year renewal	70.00
Substance abuse monitoring surcharge (assessed at $25.00 each year as stipulated in RCW 18.71A.020(3))	((25.00)) 50.00
Expired license reissuance	35.00
Duplicate license	15.00

[Statutory Authority: RCW 18.71.017 and 18.71A.020(3).  99-13-087, § 246-918-990, filed 6/14/99, effective 7/15/99.  Statutory Authority: RCW 43.70.280.  98-05-060, § 246-918-990, filed 2/13/98, effective 3/16/98.  Statutory Authority: RCW 18.71.017 and 18.71A.020.  96-03-073, § 246-918-990, filed 1/17/96, effective 2/17/96.  Statutory Authority: RCW 43.70.040.  91-06-027 (Order 131), § 246-918-990, filed 2/26/91, effective 3/29/91.]

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